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MICHAEL C. KIM PT
NPI 1669436986
Physical Therapist - Orthopedic in Lawrenceville, GA

Active since April 13, 2006Accepts Medicare Assignment
758 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045(678) 985-7190(678) 985-7158 Get Directions Write a Review

NPPES record last updated: April 8, 2008. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Michael C. Kim Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL C. KIM PT (NPI 1669436986) is an individual orthopedic provider in Lawrenceville, Georgia, licensed in Georgia (PT007802) and active in the NPI registry since April 2006. He is a graduate of Other (2003).

NPPES Registry Identity

NPI1669436986
Entity TypeIndividualMale
Primary Taxonomy2251X0800X
Provider Legal NameMICHAEL C. KIMCredential: PT
Location Address758 OLD NORCROSS RDLawrenceville, GA 30045-3385
Mailing Address758 Old Norcross RdLawrenceville, GA 30045-3385 · (678) 985-7190 · Fax (678) 985-7158
Phone(678) 985-7190
Fax(678) 985-7158
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateApril 13, 2006
Last NPPES UpdateApril 8, 2008
✔ NPI 1669436986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251X0800X
License✔ Licensed in GA · PT007802
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.
758 OLD NORCROSS RD, Lawrenceville, GA 30045
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Other Identifiers 2

Medicare UPINQ30076GA
Medicare ID-Type Unspecified65BBCSMGA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Michael C. Kim Pt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860458452
PECOS Enrollment IDI20041206000613

Medicare Billing Reassignment

Medicare enrollment records show Michael Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Resurgens, LLC
19 mi
Orthopaedic Surgery
5671 PEACHTREE DUNWOODY RD STE 900
Atlanta, GA 30342
  • Reassigned Medicare billing, Georgia enrollment
  • 223 clinicians in this Medicare group
NPI 1386697928 (404) 847-9999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK R. ICENOGLE AT-C
Specialist/Technologist (Athletic Trainer)
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 985-7190
ALICE A. HULL PTA
Physical Therapy Assistant
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 985-7190
NORTH ATLANTA ENDOCRINOLOGY AND DIABETES, PC
Specialist
758 OLD NORCROSS RD, SUITE 175
LAWRENCEVILLE, GA 30045
Gwinnett County (770) 339-1387
TYHANNA D. ESHAM OT
Occupational Therapist
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 985-7190
JON S. STEFFEY AT-C
Specialist/Technologist (Athletic Trainer)
758 OLD NORCROSS RD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 985-7190
MRS. COLLEEN YVONNE BUTLER MS,ATC, LAT
Specialist/Technologist (Athletic Trainer)
758 OLD NORCROSS RD, SUITE 110
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 985-7190

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Kim's NPI number?

The NPI number for Michael Kim is 1669436986. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Where is Michael Kim located?

Michael Kim practices at 758 Old Norcross Rd, Lawrenceville, GA 30045. The listed phone number is (678) 985-7190.

What is Michael Kim's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Is Michael Kim enrolled in Medicare?

Yes. Michael Kim is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Michael Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Kim reassigns Medicare benefits to Resurgens, LLC (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michael Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Michael Kim was last updated on April 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.